Bipolar Mania and Bipolar Depression Flashcards

1
Q

What are 4 categories of symptoms associated with bipolar disorder with examples?

A

Manic Mood and Behavior Dysphoric or Negative

 Euphoria
 Grandiosity
 Pressured speech
 Impulsivity
 Excessive libido
 Recklessness
 Social intrusiveness
 Diminished need for sleep

Psychotic Symptoms
Delusions
Hallucinations

Dysphoric or Negative
Mood and Behavior
 Depression 
 Anxiety
 Irritability
 Hostility
 Violence 
 suicide
Thought /cogniiveDisorder
 Racing thoughts
 Distractibility
 Flight of ideas
 Inattentiveness
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2
Q

What are some disorders that bipolar individuals are commonly diagnosed with in order from most common to least common? How long does is it usually take for bipolar invividuals to be correctly diagnosed?

A

Depression, anxiety. schizophrenia, borderline/antisocial, alcohol/substance abuse, schizoaffective.

41% of those diagnosed with BP go 10 years before that happens.

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3
Q

What are mixed states?
What is Mixed Mania Dysphoric Mania Depressive Mixed states? Based on age, who is most like to present with mixed states?

A

Manic and Depressive symptoms at same time. Younger people much more likely to pressent that way than older.

Mixed Mania -Full mania/full MDE at same time..

Dysphoric Mania-Full Mania/2+ MDE symptoms

Depressive Mixed states-2+mania symptoms/Full MDE

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4
Q

What is unique about the epidemiology of rapid cycling bipolar disorder? Explain why this possibly might be the case?

A

Rapid-cycling 3:1(F:M); higher if >12 episodes/year

Possibly due to:

§ Higher rates of hypothyroidism (women > men)

§ Increased antidepressant use

§ Hormonal effects

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5
Q

What is the prevalence of BPD? Age of onset? Suicide rate? Correct diagnosis rate? Unipolar depression diagnosis rate?

A

Nationwide survey evaluated prevalence using mood disorder questionnaire

(MDQ)

Prevalence of 3.7% vs. previously accepted 1%

Onset highest in 18 - 24 age range

1 in 5 are diagnosed correctly

1 in 3 are initially diagnosed with unipolar

major depression

Suicide completion rate in bipolar as high as 10 - 15%

Minorities may be overdiagnosed as schizophrenic1

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6
Q

What are 5 medical comorbidities associated with BPD? 6 Psychiatric?

A

Diabetes mellitus, pain disorders, migraine, CV, obesity

Personality disorders, ADHD, substance abuse, impulse control, anxiety disorders, eating disorders

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7
Q

What is the mortality rate like for those that are treated/untreated? What is the most common cause?

A

Higher for those untreated of most everything such as CV, stroke, cancer, accident, etc. but especially from suicide.

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8
Q

When are the peak suicide time?

A

The several studies that have appeared since this figure was constructed continue to show the

main peak in the spring (may) and a smaller peak in the fall* (october)

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9
Q

What are some structural changes that occur in the brain with BPD progression (multiple episodes)?

A

Prefrontal Cortex ↓ L inf with ↑ illness duration

↓ gray matter volume with ↑ age

Striatum
No difference in putamen between first and multi-episode patients3

Cerebellum
↓ cerebellar vermis volume in multi- vs first episode patients

Amygdala
↑ amygdala volume with ↑ age in young patients

Ventricles
↑ ventricular volume in multi- vs first episode patients
↑ ventricular volume with ↑ number of manic episodes
↑ ventricular volume with ↑ number of affective episodes

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10
Q

What are some cues that can tell you that what looks like unipolar depression might be bipolar depression?

A

Early age of onset (5-29 years)

Postpartum onset

Hyperphagia and Hypersomnia (reversed

vegetative Symptoms)

Psychomotor slowing

Severe anhedonia

Depression with catatonic and/or psychotic features

Family history of bipolar illness or mood swings

History of AD- induced mania or hypomania

History of brief hypomania or mood swings

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